Organization
ACME MARKETS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMOND HAWKINS (THIRD PARTY MANAGER)
(208) 395-3920
Entity
Organization
Contact information
Practice address
DELSEA DR AND HESTON RD, GLASSBORO, NJ 08016
(856) 582-5038
(856) 881-1634
Mailing address
3030 CULLERTON ST, FRANKLIN PARK, IL 60131-2205
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00560200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3139575
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
7569807
—
NJ
Enumeration date
05/26/2006
Last updated
01/19/2018
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